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Open Access Research article

Hepatic steatosis in HIV-HCV coinfected patients receiving antiretroviral therapy is associated with HCV-related factors but not antiretrovirals

Valrie Martinez12*, Thi Dieu Ngan TA3, Zahra Mokhtari4, Marguerite Guiguet5, Patrick Miailhes6, Marc-Antoine Valantin25, Frderic Charlotte7, Philippe Bertheau8, Jean-Michel Molina9, Christine Katlama25 and Eric Caumes25

Author Affiliations

1 Service de Mdecine Interne et Immunologie Clinique, Assistance Publique-Hpitaux de Paris, INSERM UMR_S 996, Universit Paris Sud, Hpital Antoine Bclre, 157, rue de la Porte de Trivaux, 92141, Clamart, France

2 Service des Maladies Infectieuses et Tropicales, Hpital Piti-Salptrire, Universit Pierre et Marie Curie, APHP, 45/83 Boulevard de lHpital, 75013, Paris, France

3 Departement of Infectious Disease, Hanoi Medical University, 01, Ton That Tung Street, Hanoi, Vietnam

4 Departement of Internal Medicine, Hospital National Iranian oil company, Hafez Avenue, Tehran, Iran

5 INSERM U943, UPMC Univ Paris 06, UMR S943, Paris, F-75013, France

6 Service de Maladies Infectieuses et Tropicales, 103 Grande-Rue de la Croix-Rousse, Hpital de la Croix-Rousse, Hospices Civils de Lyon, 69317 Lyon cedex 04, Paris, France

7 Service dAnatomopathologie, Hpital Piti-Salptrire, Universit Pierre et Marie Curie, APHP, 45/83 Boulevard de lHpital, 75013, Paris, France

8 Service dAnatomopathologie, Hpital Saint-Louis, Universit Denis Diderot, APHP, 1, avenue Claude Vellefaux, 75010, Paris, France

9 Service des Maladies Infectieuses et Tropicales, Hpital Saint-Louis, Universit Denis Diderot, APHP, 1, avenue Claude Vellefaux, 75010, Paris, France

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BMC Research Notes 2012, 5:180  doi:10.1186/1756-0500-5-180

Published: 10 April 2012

Abstract

Background

In HIV and hepatitis C virus (HCV) coinfected patients, the role of antiretroviral therapy (ART) on hepatic steatosis (HS) remains controversial.

Methods

HIV/HCV coinfected patients receiving ART and previously untreated for HCV who underwent a liver biopsy were included. Cumulative duration of exposure to each antiretroviral was recorded up to liver biopsy date. Logistic regression analyses evaluated factors associated with steatosis and its severity.

Results

184 patients were included: median age 41years, 84% male, 89% Caucasian, 61% with a past history of intravenous drug use. HCV genotypes were 1 (55%), 2 (6%), 3 (26%), and 4 (13%). Median HCV-RNA was 6.18 log10 IU/ml. HIV-RNA was undetectable (<400 copies/ml) in 67% of patients. Median CD4 count was 321/mm3. All patients had been exposed to nucleoside reverse transcriptase inhibitors (median cumulative exposure 56months); 126 received protease inhibitors (23months), and 79 non-nucleoside reverse transcriptase inhibitors (16months). HS was observed in 102 patients (55%): 41% grade 1; 5% grade 2, and 9% grade 3. In multivariate analysis, HCV genotype 3 and HCV viral load were moderately associated with mild steatosis but strongly with grade 2-3 steatosis. After adjustment for the period of biopsy, no association was detected between HS and exposure to any antiretroviral class or drug, or duration of ART globally or comparing genotype 3 to others.

Conclusions

Among our ART-treated HIV-HCV cohort predominantly infected with genotype 1, 55% of patients had HS which was associated with HCV-related factors, but not ART class or duration of exposure.

Keywords:
HIV; HCV; steatosis; antiretroviral drugs; genotype 3